Vital Recordhttps://vitalrecord.tamhsc.edu
News from the Texas A&M Health Science CenterWed, 13 Dec 2017 21:04:15 +0000en-UShourly1https://i2.wp.com/vitalrecord.tamhsc.edu/wp-content/uploads/2016/02/cropped-Screen-Shot-2016-02-03-at-2.37.26-PM.png?fit=32%2C32&ssl=1Vital Recordhttps://vitalrecord.tamhsc.edu
3232139939552Get to know: Eunice Fafiyebihttps://vitalrecord.tamhsc.edu/get-know-eunice-fafiyebi/
Wed, 13 Dec 2017 15:31:51 +0000http://vitalrecord.tamhsc.edu/?p=35479Meet Eunice Fafiyebi, a first-generation Aggie from Ibadan, Nigeria, who is earning her bachelor of science in public health from Texas A&M School of Public Health this December. Fafiyebi was also a member of the Corps of Cadets and served the university as a member of the Maroon Coats. She plans to become a global

]]>Meet Eunice Fafiyebi, a first-generation Aggie from Ibadan, Nigeria, who is earning her bachelor of science in public health from Texas A&M School of Public Health this December. Fafiyebi was also a member of the Corps of Cadets and served the university as a member of the Maroon Coats. She plans to become a global pediatric surgeon and health policy advocate. Vital Record spoke to Fafiyebi on her Texas A&M experience, aspirations and views on health care:

Q: What made you take an academic interest in health care?

A: I have sickle cell anemia, a genetic disease where you don’t have enough healthy red blood cells to carry enough oxygen throughout your body. Growing up, I was always sick and in a hospital. The health care in my birthplace, Nigeria, was not that great. That’s why my parents were very excited about coming to America: Over here, health care is far better. I was treated by amazing doctors, they worked with me to find medication that actually helped my condition. I am learning to take care of myself and live with this disease. My life is physically better because of being in America.

Q: How did you immigrate to the United States?

A: Each year when I was growing up, my parents applied for the Diversity Visa, which makes available 50,000 permanent resident visas annually to persons from countries with low rates of immigration to the United States. You fill out an application, and the computer selects your number, basically like a lottery. Once your name is picked, you go through a screening process and clinic testing, and finally you are called for an interview at the U.S. Embassy, where it’s decided whether you get to go or not. We got the visa in 2007 and arrived here in 2009; it’s a long process.

Q: Why did you choose Public Health at Texas A&M University?

A: I started as a biomedical science major, but it never really felt right for me. When I spoke to my advisor in the Corps of Cadets, I mentioned that I enjoy volunteering and talking to people, and I was encouraged by my advisor to look into public health. The next semester, I enrolled in an introduction to public health class, and that just blew me away. I loved being a part of health care and understanding how factors that are outside the hospital also affect health, like policy, for example.

We didn’t have health insurance or a government health care program in Nigeria; we were essentially on our own. I have seen health care from outside the United States, and as an immigrant, I have benefitted from the Affordable Care Act, which makes health insurance available to more people. I am fascinated with health policy in America, where it will go and who will benefit from it, and how it will evolve. I’ve had the opportunity to see it from both the outside and the inside, as well as study it formally in my coursework.

Q:How would you describe your experiences with the Corps of Cadets and Maroon Coats?

A: The Corps was like a fulltime job. The Reserve Officers’ Training Corps program prepares you for being in the military. I always wanted to join the military, but I knew I couldn’t because I was born with sickle cell anemia. This was my chance for a military experience. I was really attracted to the uniform and being in a leadership organization. During my last semester in the Corps, I was a Career Readiness Officer. I planned the interview and resume workshops that helped students get jobs and prepare for life after college. I got to play a role in people’s futures, which was really cool.

In the Maroon Coats, you are the connection between the donors and students. We spent time with donors, told them our stories and helped them see what impact they are making at Texas A&M, which is a lot. It was an honor to be with the Maroon Coats.

Q: What are your post-graduation plans?

A: I want to go to medical school; I would like to be in the Texas A&M College of Medicine; I love it here.

Q: How has earning a degree in public health prepared you for a career as a physician?

A: Public health has taught me to look beyond the patient. I have been a patient and in hospitals, and when you’re in that situation, you don’t think about all that impacts health care. There is a great “beyond” from that one person in that one hospital room. When you see a patient, you see the disease, but there is so much more to that. The disease could be due to genetics, or not getting to the doctor on time because the person could not afford insurance or simply lacked the time or transportation to get there. There is a lot more than meets the eye, a lot of social and cultural implications behind the patient. In the future, I won’t just be seeing sick patients, but rather factoring in what their genetics, parents and communities look like.

Q: What is your long-term goal?

A: I would like to be a pediatric surgeon and travel and practice medicine, and help other cultures. God has given me a gift to be here, and I want to give this gift back as much as I can. I would love to work with the United Nations or World Health Organization and help support health policy from there. I have been in a rural setting in Nigeria. I have seen people pass away due to not having a nurse or doctor, or simply not knowing basic health care, like drinking more water. I would like to go back, perform as a general surgeon and reduce the death rate, if I can.

Q: Do you have any advice for those wanting to pursue a degree in public health?

A: Be open minded; I came here wanting to learn what is out there, and that really helped. You will see how you and the environment are impacted with public health. You will learn concepts, so understand how these concepts can impact your community.

]]>35479Croup: Signs and symptomshttps://vitalrecord.tamhsc.edu/croup-signs-symptoms/
Wed, 13 Dec 2017 14:48:44 +0000http://vitalrecord.tamhsc.edu/?p=35470Seeing your child sick can be a parent’s worst nightmare, and it’s easy to assume the worst. Sometimes it’s something they picked up from school, or day care or the playground, or it can just be from something at home. Your youngster’s immune system is in its developing stages, and that can lead to some

]]>Seeing your child sick can be a parent’s worst nightmare, and it’s easy to assume the worst. Sometimes it’s something they picked up from school, or day care or the playground, or it can just be from something at home. Your youngster’s immune system is in its developing stages, and that can lead to some unusual pathogens plaguing your child’s health.

One of those illnesses is laryngotracheobronchitis (LBT), more commonly known as croup, and Alison Pittman, PhD, CPN, RN, clinical assistant professor at the Texas A&M College of Nursing, talks about this common childhood ailment.

What is Croup?

Croup is a viral respiratory infection that swells the vocal cords and has other cold-like symptoms. However, the effect the illness has on the respiratory tract is what leads to its more telling symptom.

“Croup is typically caused when the larynx and trachea get infected,” Pittman said. “The patient may develop mild symptoms common to many infections, like a fever or runny nose, but their cough will sound distinctive, like the bark of a seal or a dog.”

The infection can interfere with normal breathing and can also cause a hoarse voice and stridor—a high-pitched wheezing sound caused by disrupted airflow.

Although this illness is mostly found in kids, adults can occasionally become infected. However, children are more likely to experience complications from the illness.

Complications

Croup is usually caused by a virus, so it can’t be treated by antibiotics and is normally self-limiting, which means that children will get better on their own within a few days. Give your child proper amounts of acetaminophen for their fever as recommended by your provider, and make sure that they are drinking plenty of fluids. Also, a humidifier at home could also help lessen your child’s cough by moistening dry air.

However, it is possible to have complications from the illness. With croup, your child’s airway is compromised, so it’s best to monitor their breathing.

“Children and babies have smaller airways, so when their larynx gets swollen, it could lead to serious complications,” Pittman said. “If your child has trouble breathing, is restless, lethargic, breathing faster than usual, or has noisy, high-pitched whistled breathing, then take them to the emergency room right away where they can receive treatment to help them breathe.”

Avoiding the virus

We have all heard about flu season, but croup has its season, too. Croup is most common in the fall and winter; however, it is possible to get the condition outside of this time frame. And unlike the flu, there is no vaccine for croup.

However, the best way to avoid croup is through proper hygiene, especially since croup is contagious during the first few days, or as long as the child has a fever.

“As long as your child has a fever, you want to keep them home from school or daycare,” Pittman said. “Practice good hygiene and preventative measures, such as proper handwashing and covering a cough. The virus is spread by contact or by droplets, so be sure to disinfect surfaces or areas that your child has come into contact to limit the risk of spreading the virus.”

]]>35470Moving memory: Regular exercise significantly reduced risk of dementiahttps://vitalrecord.tamhsc.edu/moving-memory-regular-exercise-significantly-reduced-risk-dementia/
Tue, 12 Dec 2017 16:01:15 +0000http://vitalrecord.tamhsc.edu/?p=35438Globally, more than 47.5 million elderly people are living with dementia. Dementia brings memory loss, decreased self-care and reduced quality of life and is a leading cause of mortality in older adults. Taking care of dementia patients is much more costly and burdensome than caring for any other chronic disease. To date, there is no

]]>Globally, more than 47.5 million elderly people are living with dementia. Dementia brings memory loss, decreased self-care and reduced quality of life and is a leading cause of mortality in older adults. Taking care of dementia patients is much more costly and burdensome than caring for any other chronic disease. To date, there is no effective treatment available for dementia, so there is an urgent need for prevention. Some research has suggested that exercise could prevent dementia, but the evidence is inconclusive. Furthermore, these earlier studies were limited in terms of having small sample sizes, short follow-up times or being cross-sectional (one-time measurements).

To address these literature gaps, Y. Alicia Hong, PhD, associate professor in the Department of Health Promotion and Community Health Services at the Texas A&M School of Public Health, and colleagues at Xiamen University in China, carried out a longitudinal study with a large sample of elderly people in China.

In this study, which was published in the journal BMJ Open, the researchers examined data from four waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 2002 and 2012 to look for the relationship of regular exercise and dementia in older adults. Of the 7,501 older Chinese people, 338 people developed dementia during the 10-year follow-up period. (Those who had died or who couldn’t be found by the end of the 10-year period were not counted.) People who regularly exercised had lower odds of developing dementia than those who did not, even after controlling for other factors—such as age, education, smoking, hypertension and diabetes—that may impact dementia risk.

“We found that exercise significantly reduced the risk of dementia,” Hong said. “More importantly, our study drew a nationally representative sample of older adults, and they were followed for 10 years.”

The study authors list a few possible mechanisms for this association, such as exercise affecting gene expression or providing some other type of protective effect. Another possibility is that regular exercise goes along with other healthy lifestyle factors, such as gardening and being socially active, which can keep the brain stimulated.

“Although we don’t know yet exactly how exercise helped lower the risk of dementia, our study shows very clear evidence that it does, and it costs almost nothing,” Hong said. “This information will be crucial for physicians and public policy makers who will be tasked with developing effective ways to promote exercise in older adults. Such interventions will become even more important as the size of the older population grows.”

]]>35438Solving the medical mysteries of space flighthttps://vitalrecord.tamhsc.edu/solving-medical-mysteries-space-flight/
Tue, 12 Dec 2017 16:00:34 +0000http://vitalrecord.tamhsc.edu/?p=35398When male astronauts spend weeks or months in space, a strange thing happens to their eyesight: They go from having the perfect vision required to make it into the space program to having, at best, a mild vision impairment. For male astronauts (so far, only men have been shown to be affected) wanting to make

]]>When male astronauts spend weeks or months in space, a strange thing happens to their eyesight: They go from having the perfect vision required to make it into the space program to having, at best, a mild vision impairment. For male astronauts (so far, only men have been shown to be affected) wanting to make the trek to Mars one day, this would be disastrous, since the mission will take a few years—just imagine arriving on Mars and not being able to see well enough to land.

“We think that’s why NASA is so interested in our work,” said David Zawieja, PhD, Regents Professor at the Texas A&M College of Medicine. He’s the lead investigator for the lymphatics portion of a recent space flight experiment examining the effect of microgravity on eyesight that sent 20 animal models into space to live on the International Space Station for about a month as part of NASA’s Vision Impairment and Intracranial Pressure program.

“We believe that increases in pressure, which propagate down the cranial nerve to the eye, may help explain the vision changes we’re seeing in astronauts,” Zawieja said. The team looked for vascular changes that may affect pressure of cerebral spinal fluid, the clear liquid found in the brain and spinal cord, and factors involved in its regulation. However, this was only one part of the multi-institution, multi-team project.

A second team from Texas A&M examined coronary artery function. “We were the first researchers ever to study isolated coronary vessels following spaceflight,” said Pooneh Bagher, PhD, assistant professor at the College of Medicine and the lead investigator on this part of the project. “The heart is a unique organ, and if you have some coronary artery dysfunction, you could have heart dysfunction which would affect the entire body.”

Zawieja and his colleagues worked with NASA before to study the effect of the space environment on cerebral blood and lymph vascular functions, but these were done using mostly simulated microgravity, not actual space flight.

Now, in collaboration with principal investigator and longtime collaborator Michael Delp, PhD, formerly at Texas A&M and now at Florida State University, the team studied the effects of actual space flight on these 20 animal models that were launched from the Kennedy Space Center in early August. After the models landed in the Pacific Ocean in September, all of the research teams went to Loma Linda University in California to conduct experiments immediately upon landing. “It’s important that the animals have as little exposure to earth gravity as possible, which is why we went to California to conduct the research,” Zawieja said.

Next, the entire team will pack up and move to Kennedy Space Center to compare the results of the animals in space with two control groups on the ground.

Although the effects of space flight on the body is an exceptional situation, the team says that it has potential to help them understand the human body in new ways and master techniques that can help them in future studies, whether related to space travel or not. “We are looking at how a very unique thing affects physiology,” Bagher said. “Working in this environment has changed the way we think about science.”

Working on NASA-sponsored projects has been an amazing experience for Zawieja as well. “I’ve really been a space geek since I was a little kid,” he said. “What’s really fun about NASA work is the teamwork aspect. We have the opportunity to work with a wonderful team of colleagues from many institutions to solve a problem that NASA has, one that will affect the entire future of space exploration.”

]]>35398On a mission, right here at homehttps://vitalrecord.tamhsc.edu/mission-right-home/
Tue, 12 Dec 2017 15:59:49 +0000http://vitalrecord.tamhsc.edu/?p=35435 Texas A&M College of Medicine was created to serve the people of central Texas, particularly medically underserved populations. As an extension of Texas A&M, the Texas A&M Physicians Family Medicine Clinic (TAMP) is delivering on that promise in Aggieland. With a main practice clinic in Bryan, Texas, and a satellite clinic in Navasota, Texas,

Texas A&M College of Medicine was created to serve the people of central Texas, particularly medically underserved populations. As an extension of Texas A&M, the Texas A&M Physicians Family Medicine Clinic (TAMP) is delivering on that promise in Aggieland.

With a main practice clinic in Bryan, Texas, and a satellite clinic in Navasota, Texas, TAMP combines the missions of healing, prevention and medical education. TAMP is the only one of its kind in the twin cities, and it’s making an impact on the residents of 17 counties in central Texas—which are mostly rural, medically underserved or both.

Why is it unique? TAMP serves the local community by providing services that positively influence some of the most costly preventable diseases in the area through primary care services, obstetric and gynecological care, cancer screening and sports medicine—and it’s also home to the Texas A&M Family Medicine Residency, the only residency in Bryan-College Station.

In addition to being a stand-alone clinic, TAMP seeks to serve a population that may otherwise not receive health care, and staff members are trained to make sure that those who can’t afford it and those who can’t find transportation are still able to access services.

Access to care is especially important in family medicine, which treats many of the preventive and chronic diseases that are some of the most prevalent and costly burdens on modern day health care, significantly affecting the quality of life for Texans. Chronic disease accounts for 75 percent of Texas health care expenditures.

The clinic is just six years old, but it has already made strides in helping the community. TAMP was recently awarded national recognition for patient-centered care and designated as a National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH). The award recognizes clinics for using evidence-based, patient-centered processes that focus on highly coordinated care and a greater-than-usual commitment to continuity for patients and physicians.

TAMP is able to quickly make diagnostic decisions and increase the speed of treating patients with point of care testing, an endoscopy suite, in-clinic X-rays with a full-time technician and vascular, obstetrical and orthopedic ultrasounds.

Morgan Hines, MD, a resident with TAMP, says the variety is certainly beneficial for her training.

“You never really know what you’re going to see on any given day,” Hines said. “We might be performing endoscopies in the morning, delivering a baby over lunch and admitting a patient to the ICU in the afternoon. I believe this residency is about pushing limits.”

In addition to a commitment to full-scope family medicine, the residency and TAMP specialize in the care of underserved and rural populations—part of the Texas A&M University Health Science Center and Texas A&M College of Medicine’s priorities.

“We are a community-based program,” said Rae Adams, MD, director of the Texas A&M Family Medicine Residency. “We are training our residents to become community leaders while honing the skills to do high-risk and surgical obstetrics, endoscopy and both inpatient care and outpatient procedures.”

TAMP and its residents provide care to a local prenatal clinic, which cares for the mothers of more than 25 percent of the children born in Brazos County. This not only increases the impact that the clinic has on patients, it also gives residents prenatal experiences they wouldn’t see through other clinical experiences.

As the home to the Texas Cancer Screening, Training, Education and Prevention Program (C-STEP), TAMP provides critical safety-net services, such as cancer screenings and certain advanced diagnostics, to uninsured, underserved and low-income Texans. Texas C-STEP is funded by grants from the Cancer Prevention & Research Institute of Texas. The grants provide much needed access to women’s health services and colonoscopy, while also enhancing screening capacity and physician training. The program serves as a state and nationwide model for translating cancer screening services, such as colonoscopy, into the family practice setting.

In its first three years, the grant has provided for 373 clinical breast exams, 993 mammograms, 203 breast ultrasounds, 43 breast biopsies, 474 Pap tests, 215 colposcopies (a way of diagnosing cervical issues) and 49 loop electrosurgical excisions, or LEEPs, another way of diagnosing and curing problems of the cervix. The program has also likely reached 161,000 people through television, radio, brochures and other outreach and 5,177 people have been educated one-on-one by community health workers. There have been 11 breast cancers and 2 cervical cancers found and 141 cervical cancer precursors diagnosed.

Uninsured or underinsured women living in any of the 17 counties who qualify based on their income level, which can be up to 250 percent of the Medicaid federal poverty guidelines are eligible to participate. They are women between 21 through 64 years of age and are the group least likely to be covered by Medicare or Medicaid. They are also among the ages that need the tests the most: Screening mammograms are recommended every two years for women 50 to 74 years of age, and Pap tests are recommended every three years for women aged 21 through 64.

Now, TAMP is able to meet women in their area towns through “mobile mammogram days” funded under the grant. These units can travel to rural counties and provide screenings in accessible locations like churches and community centers for patients that otherwise wouldn’t be able to be screened.

Simply put, TAMP is the clinical extension of the Texas A&M College of Medicine’s historical roots. The college, which celebrated its 40th anniversary in 2017, was created by a federal act that created new medical schools across the country. The purpose of these medical schools was to care for underserved populations. As the home to numerous outreach programs, clinical care and residency training, TAMP is helping Texas A&M deliver on this mission.

]]>35435Byington named fellow of the National Academy of Inventorshttps://vitalrecord.tamhsc.edu/byington-named-fellow-national-academy-inventors/
Tue, 12 Dec 2017 15:31:44 +0000http://vitalrecord.tamhsc.edu/?p=35459Carrie L. Byington, MD, dean of the Texas A&M College of Medicine, senior vice president of the Texas A&M University Health Science Center and vice chancellor for health services at The Texas A&M University System, has been named a Fellow of the National Academy of Inventors (NAI), the organization announced Tuesday. A federally funded investigator

]]>Carrie L. Byington, MD, dean of the Texas A&M College of Medicine, senior vice president of the Texas A&M University Health Science Center and vice chancellor for health services at The Texas A&M University System, has been named a Fellow of the National Academy of Inventors (NAI), the organization announced Tuesday.

A federally funded investigator with continuous support as principal or co-investigator totaling about $80 million since 1998, Byington’s research spans the translational spectrum from basic laboratory science to health services research. Working with a group of laboratory scientists and engineers, Byington helped develop a diagnostic system called FilmArray with BioFire Diagnostics in Salt Lake City, Utah, to determine the cause of fever. Now, FilmArray, with panels that can be used to identify almost 100 different pathogens, is used in thousands of hospitals in North America and all over the world to diagnose causes of fever, respiratory or gastrointestinal illnesses, and even meningitis or sepsis.

Election to NAI Fellow status is the highest professional accolade bestowed solely to academic inventors who have demonstrated a prolific spirit of innovation in creating or facilitating outstanding inventions that have made a tangible impact on quality of life, economic development and welfare of society.

Byington has had numerous career accomplishments including election into the National Academy of Medicine and awards from the Robert Wood Johnson Foundation, the Association of American Medical Colleges, American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the National Institutes of Health. She currently serves as Chair of the American Academy of Pediatrics Committee on Infectious Diseases, which prepares all policies related to pediatric infectious diseases and vaccines and produces the Red Book—a resource used by pediatricians around the world in the treatment of childhood infectious diseases.

With the election of the 2017 class, there are now 912 NAI Fellows, representing over 250 research universities and governmental and non-profit research institutes. The 2017 Fellows are named inventors on nearly 6,000 issued U.S. patents, bringing the collective patents held by all NAI Fellows to more than 32,000 issued U.S. patents.

Byington will be inducted as part of the Seventh Annual NAI Conference of the National Academy of Inventors at the Mayflower Hotel, Autograph Collection in Washington, D.C., in April.

The 2017 class of NAI Fellows was evaluated by the 2017 Selection Committee, which included 18 members comprising NAI Fellows, U.S. National Medals recipients, National Inventors Hall of Fame inductees, members of the National Academies of Sciences, Engineering, and Medicine and senior officials from the USPTO, National Institute of Standards and Technology, Association of American Universities, American Association for the Advancement of Science, Association of Public and Land-grant Universities, Association of University Technology Managers and National Inventors Hall of Fame, among other organizations.

]]>35459Texas’ alarming maternal mortality rateshttps://vitalrecord.tamhsc.edu/texas-alarming-maternal-mortality-rates/
Thu, 07 Dec 2017 21:05:47 +0000http://vitalrecord.tamhsc.edu/?p=35414There have been a number of stories in the media recently about women dying or nearly dying during pregnancy or shortly postpartum. Once thought of as a largely historical issue, or one that only affected women in the developing world without access to modern medicine, people around the country seem to be increasingly recognizing the

]]>There have been a number of stories in the media recently about women dying or nearly dying during pregnancy or shortly postpartum. Once thought of as a largely historical issue, or one that only affected women in the developing world without access to modern medicine, people around the country seem to be increasingly recognizing the problem. And it is indeed a problem: The United States has the worst maternal mortality rate of any developed country, with an estimated 26.4 maternal deaths for every 100,000 live births in 2015. Perhaps just as alarming, this number has been rising since 1990 while the rate of most other countries in the world is dropping. In fact, the United States was one of eight countries where maternal death rates worsened between 2003 and 2013.

Texas has a high number of pregnancy-related deaths when compared to other states. “Our death rate in Texas has gone up,” said Shelley White-Corey, MSN, registered nurse and women’s health nurse practitioner and a clinical assistant professor at the Texas A&M College of Nursing. “Some states, like California for example, are doing a good job bringing their numbers down, but we haven’t been able to do the same for reasons that aren’t quite clear. However, there are certain factors that we know put women at higher risk of complications.”

Some of these risk factors are increased maternal age. In the United States, more first-time pregnancies are occurring in older women, with more complex medical histories, than in previous years. “Additionally, half of all pregnancies in the United States are unplanned, so many women with chronic medical issues like hypertension or diabetes do not seek medical stabilization before pregnancy occurs,” said Hector O. Chapa, MD, FACOG, clinical assistant professor of obstetrics and gynecology at the Texas A&M College of Medicine.

It’s also perhaps maternal mortality’s relative rareness—at least compared to deaths from conditions like cancer or heart disease—that makes it especially difficult to combat when it does occur.

“Childbirth complications don’t happen very often, but when they do, it can be serious,” White-Corey said. That’s why the Texas A&M Colleges of Nursing and Medicine conduct simulations to train future physicians and nurses how to respond to these sorts of pregnancy and birth complications before they ever enter a clinic or hospital.

“One of the things we stress to our students in our simulation is how important it is to have a well-functioning team because we don’t have time for communication breakdowns,” White Corey added. “Someone needs to take charge of the situation or you won’t have a good outcome for the mother and the baby.”

On a larger scale, Texas is trying to address the issue by extending the work of a state Maternal Mortality and Morbidity Task Force through 2023 and by having the task force study what other states are doing to curb their own rates. The legislature also added a labor and delivery nurse and a critical care physician to the task force. “I think these are positive steps that will hopefully help us lower the rate of new mothers dying in Texas,” White-Corey said.

Oddly, however, this issue of increasing maternal mortality is in paradox to perinatal mortality. Infant mortality has fallen to its lowest rate in over 30 years. Organizations like the March of Dimes, together with advocacy groups for women’s care, have brought attention to things like elective cesarean sections and their potential risks, early elective inductions and other pregnancy conditions that have now been addressed to improve neonatal outcomes.

Of course, sometimes inducing labor is necessary for the health of the mother or the baby. Thanks to Kim Kardashian West having the condition, many more people now have heard of placenta accreta, a potentially dangerous condition in which the placenta attaches itself too deeply to the uterine wall. This can lead to the mother losing more blood than her body can handle very quickly. That’s why ACOG recommends delivery at 34 weeks of gestation in an operating room ready to handle potential complications.

Unfortunately, although the condition can be seen on an ultrasound, if a woman hasn’t been receiving good prenatal care, she might not know she has placenta accreta until it is too late.

Another common reason why a physician might recommend induction of labor is preeclampsia, in which a woman develops dangerously high blood pressure that can lead to seizures or strokes. Although researchers are working on ways to reverse the condition early in a pregnancy, in the meantime, it’s important for women to know how to recognize the symptoms. “If you are pregnant and start experiencing severe headaches or right upper quadrant pain or you start seeing spots, call your provider right away,” White-Corey said.

Although these conditions specific to pregnancy, along with unforeseeable catastrophic medical events and medical errors, have featured prominently in many of the news reports of mothers dying during pregnancy or soon after, they do not explain the current maternal mortality trends, according to Chapa. “Although preventable medical errors are a known cause of patient harm nationally, and worldwide, medical errors are not the main factor at play here,” he said. “Obstetrics possesses unique maternal physiological changes that may result in devastating and catastrophic maternal events—despite advances in medical practice.”

One of the best ways to reduce the risks is to provide better access to prenatal care. “Getting care early in the pregnancy is so important because it helps catch conditions early,” White-Corey said.

Limited access to early prenatal care in lower socioeconomic groups is especially concerning, according to the Society for Maternal Fetal Medicine, because there are discrepancies in maternal mortality rates based on race and ethnicity that could be explained by differing levels of access to prenatal care early in pregnancy. “Maternal mortality in the United States, for example, disproportionately affects black women,” Chapa said. “And mothers in the lower socioeconomic groups are the ones who suffer the consequences the most.”

Unfortunately, even if they’ve had the best prenatal care, women aren’t out of the woods once the baby’s born. “Most people don’t realize that maternal suicide is one of the leading causes of death for new mothers,” White Corey said. “Many postpartum women have mood or anxiety disorders, but it’s under-discussed, underdiagnosed and undertreated.”

If women experience postpartum blues that don’t go away after a few days or if they find themselves crying for no external reason or having thoughts of hurting themselves or their babies, they need to ask for help. “Anyone with these symptoms should call her provider right away,” White-Corey said. “Many women are focused entirely on their new baby during this time, but they need to take care of themselves too, because proper treatment—whether that is therapy, medication or both—could help save lives.”

Clearly, the solution to maternal mortality will be multi-pronged, just like its causes are.

“While advances in medicine progress, the United States maternal mortality still rises,” Chapa said. “Better access to early prenatal care, maternal education, resources for low income areas and a state-specific focus on making maternal health a priority are all vital aspect to help reverse this distressing trend…one state at a time.”

]]>35414South Texas goes ‘all-in’ for health carehttps://vitalrecord.tamhsc.edu/south-texas-goes-health-care/
Thu, 07 Dec 2017 21:04:06 +0000http://vitalrecord.tamhsc.edu/?p=35411The name “Texas” is based on the word “tejas.” It’s a Spanish adaptation of a word used by East Texas Caddo Indians meaning “allies” or “friends.” Texas is a friendly state, and the principle of helping others can be seen in every county. The values placed on community development have laid the groundwork for future

]]>The name “Texas” is based on the word “tejas.” It’s a Spanish adaptation of a word used by East Texas Caddo Indians meaning “allies” or “friends.” Texas is a friendly state, and the principle of helping others can be seen in every county. The values placed on community development have laid the groundwork for future generations, and the idea that Texans are “friends” is something that every Texan, from Brownsville to Amarillo, can understand.

Friends care for each other, and allies help each other against enemies. And when it comes to battling enemies like chronic disease and poor health care networks, South Texas has found a new ally. Healthy South Texas is a program dedication to improving the lives of everyone in the South Texas region, in addition to setting a foundation for interdisciplinary success in education and applied research for future generations of health care professionals.

“The Rio Grande Valley has over 1.3 million citizens, many who are underserved or uninsured,” said Olga Gabriel, MPH, director of the Texas A&M University Health Science Center McAllen campus. “We wanted to have a role in the community that isn’t just academic, but is about applying the research we’re doing to community outreach and involvement.”

The need for greater medical presence in the lower Rio Grande Valley was clear. Many families in the area struggle with asthma, diabetes and infectious diseases, and many have often relied on traveling across the border to get their medication at a cheaper rate because they cannot afford to buy it in the United States.

With these health difficulties in the area, and the 1.3 million Americans in the four counties that make up the Rio Grande Valley (not including the thousands of Mexican citizens who spend time on this side of the river), improving health needed a group effort.

The Texas A&M Health Science Center McAllen campus was established in 2000, serving as the Texas A&M System’s most southern location. The campus offers a Bachelor of Science in Public Health and Master of Public Health Degree and has branches that spread wide through other disciplines of health.

“There is a desperate need for nurses in the community,” Gabriel said. “We knew we had to be more than just an academic institution, and the Health Science Center expanded to include College of Nursing faculty members with applied research who could make an immediate impact.”

The campus has become much more than just an institution of public health; it has become its own “mini” Health Science Center, with two of the five disciplines making up the entire Texas A&M University Health Science Center: nursing, and public health and occasionally pharmacy, are housed in McAllen.

“Our location served as the colloquia location for the College of Pharmacy,” Gabriel said. “The clinic next door houses our Diabetes Education Program, which is managed by administration here, and it is where College of Dentistry students will be doing their practicum.”

Poverty in the Rio Grande Valley is a major problem as well, as cities of Cameron County often top the list of America’s poorest cities. This can affect the health of a community if they have to make tough choices between paying for food, shelter or medication.

“We try to offer assistance in every way that we can, such as education and intervention programs that help reinforce a healthy lifestyle, and help deter costly chronic diseases,” Gabriel said. “We also have large events that the entire community is welcome to attend to foster community engagement and help families make healthy changes to prevent health problems later in life.”

In 2013, the Brownsville-Harlingen area had a poverty rate of 36 percent, and the McAllen-Edinburg-Mission area had an average poverty rate of 34 percent, which were the highest and second-highest poverty rates in the nation, respectively. Many of the residents were also living without health insurance, which means a community intervention was needed.

“Not only are we trying to help and educate the four counties of the Rio Grande Valley, we occasionally see the same number of people from Mexico, and we give them the same resources to improve their health,” Gabriel said. “Whether it’s through medication assistance or through the diabetes and asthma programs we have, our goal is to assist the community’s health needs.”

Some of the community events can range from medication assessment days, to a large health expo like the Our Health is Wealth Expo in McAllen in late September. The event had free programs including medication review, giveaways, information pamphlets and brochures, flu shots and much more for people in attendance.

“We hold several medication review days where residents come in with all of their medication in a bag and the College of Pharmacy students with their instructor go over the medications and make sure the participant understands how to properly take them and can suggest ways to alleviate side effects,” Gabriel said. “The McAllen Expo was almost entirely interdisciplinary involvement talking about diabetes, obesity, asthma, Zika and a whole variety of health involvement. It’s about getting the education to the people and service for the community.”

]]>35411Horizons of hope for people at risk of colorectal cancerhttps://vitalrecord.tamhsc.edu/horizons-hope-people-risk-colorectal-cancer/
Thu, 07 Dec 2017 21:03:31 +0000http://vitalrecord.tamhsc.edu/?p=35277What if we could detect colorectal cancer even before its onset? What if you could find out noninvasively whether you are developing colorectal cancer—as early as a decade before the disease would show up through a colonoscopy? Researchers at the Texas A&M Irma Lerma Rangel College of Pharmacy are working on develop biomarkers that could

]]>What if we could detect colorectal cancer even before its onset? What if you could find out noninvasively whether you are developing colorectal cancer—as early as a decade before the disease would show up through a colonoscopy? Researchers at the Texas A&M Irma Lerma Rangel College of Pharmacy are working on develop biomarkers that could do just that, based on their recent findings, published in the Journal of Biological Chemistry, about the mechanisms of colonic polyp formation.

Colorectal cancer is the second-leading cause of cancer-related deaths in the United States, after lung cancer. Colonoscopies are important, but they’re not always enough. “Too often colorectal cancer is discovered at a very late stage, which leaves the patients with a poor prognosis,” said Narendra Kumar, PhD, associate professor of pharmaceutical sciences at the Rangel College of Pharmacy and corresponding author of the article. “The big question is, how can we detect it earlier?”

To answer that, the researchers first had to understand why colorectal cancer occurs in the first place. “It all starts from small inflammation,” said Kumar, whose earlier work has focused on inflammation in the gut. “Much of our immune system resides in the gut. The immune system is a kind of fire, and microbiota is the fuel, and they must be kept separated in the intestine because if they combine, then boom! You have a blast.”

In most people, the immune system and the microbiome are kept separate by a single layer of epithelial cells called intestinal mucosa. However, if there are problems with this lining, at first it causes acute inflammation and if not resolved right away, than it leads to chronic inflammation, leading to Crohn’s disease and ulcerative colitis, which in turn lead to an increased risk for colon cancer.

“Everyday food that we eat many times causes a slight erosion of epithelial lining of the intestine and it creates a small wound,” Kumar said. This causes localized inflammation, but in healthy people, these injuries are repaired very quickly through a process called intestinal restitution or intestinal wound repair.

“When the gut is injured, the epithelial cells lose their structure and look more like mesenchymal cells in a process called epithelial mesenchymal transition,” said Jayshree Mishra, PhD, research assistant professor at the Rangel College of Pharmacy and first author of the paper. The surviving cells around the injured area start migrating to cover the wound, and if there aren’t enough of them, then they start proliferating, or increasing in number, until they do have enough cells to cover the injured area. Once the wound is covered, the cells start differentiating back into their normal cell type so that all of the cells, new and old, can function well as part of the epithelium.

“Cells have to know when to stop proliferating and start differentiating,” Kumar said. If they don’t, it causes a colonic polyp, or tumor, and if not detected in a timely manner or if the inflammation continues, then it leads ultimately to colorectal cancer development. “We have now published research that shows the mechanism that facilitates the cells to stop proliferating and transit into differentiation mode.”

The interprofessional research team Kumar leads is in the process of patenting the biomarker-based technology that can detect genetic changes that cause the ‘stop proliferating’ signal to fail. Cells with these mutations would be highly likely to turn cancerous, so the ability to detect them—when they are just a few errant cells—could make the diagnosis of colorectal cancer much earlier, before the cells have become large polyps that can be seen in a colonoscopy. The next step is to further test it clinically in large cohort of patients, so the researchers have partnered with CHRISTUS Spohn Health System.

Still, the researchers are optimistic that it will work because they have already tested the proof of the concept using a wide range of models—from the test tubes to human colorectal cancer cells to actual human colonic polyps—to reach their conclusions. The team of pharmacists, clinicians and basic scientists found that the human polyp samples verified the changes in genetics and subsequent signaling that they had seen in the cell culture. “It was very exciting to see that the molecule we expected to be decreased—based on our new understanding of the mechanism of cell proliferation—actually was,” Mishra said.

“We hope the technology will be able to detect at least 10 years before colon cancer can be found via colonoscopy,” Kumar added. “Whatever we do in the lab, at the end of the day, we must use all of our resources to help better the life of patients, and if you can increase the life expectancy of even a few persons, the research is worth doing.”

]]>35277Reducing liver fibrosishttps://vitalrecord.tamhsc.edu/reducing-liver-fibrosis/
Thu, 30 Nov 2017 15:38:37 +0000http://vitalrecord.tamhsc.edu/?p=35425Nearly half of the estimated 78,529 liver disease deaths among Americans 12 and older were related to alcoholic liver disease in 2015, according to the National Institute on Alcohol Abuse and Alcoholism. This is because over time, alcohol consumption causes abnormal fat accumulation in liver cells, called steatosis, as well as the formation of excess

]]>Nearly half of the estimated 78,529 liver disease deaths among Americans 12 and older were related to alcoholic liver disease in 2015, according to the National Institute on Alcohol Abuse and Alcoholism. This is because over time, alcohol consumption causes abnormal fat accumulation in liver cells, called steatosis, as well as the formation of excess fibrous connective tissue in the liver, a process called fibrosis. This, in turn, can lead to hepatitis, cirrhosis (scarring of the liver) and liver cancer.

A new study in The American Journal of Pathology offers insights into the cellular aging that may trigger liver fibrosis, as well as possible means to inhibit these changes, which may lead to new therapeutic approaches for patients with alcoholic liver disease.

“We believe that senescent cells contribute to age-related tissue degeneration during chronic liver injuries,” said Fanyin Meng, PhD, associate professor of internal medicine at the Texas A&M College of Medicine, researcher with Baylor Scott & White Digestive Disease Research Center (DDRC), investigator for Central Texas Veterans Health Care System (CTVHCS), and co-corresponding author of the study. “Cellular senescence refers to the irreversible stopping of the normal cell cycle combined with the secretion of pro-inflammatory compounds called cytokines. Our study demonstrates that these drivers of aging are critical mediators of alcoholic liver diseases.”

Investigators studied liver tissue from patients with fatty liver disease, or steatohepatitis, who were heavy alcohol drinkers. They also examined ethanol-fed animal models to identify biochemical markers of cellular senescence. Their findings indicate that increasing the amount of a tiny bit of genetic material called microRNA-34a during alcohol consumption contributes to the development of liver fibrosis during alcoholic liver injury. At the same time, the opposite is also true: decreasing the expression of this microRNA in the liver reduces liver injury and liver fibrosis in alcoholic liver disease.

“Targeting the drivers of aging and senescent cells may be a novel therapeutic strategy to reduce hepatic steatosis and liver fibrosis in alcoholic liver disease patients,” said co-corresponding author Gianfranco Alpini, PhD, Distinguished Professor of medical physiology at Texas A&M College of Medicine, director of DDRC and Research Career Scientist with CTVHCS.

According to the study’s findings, the up-regulation of microRNA-34a due to alcohol has different effects on the two types of cells found in the liver. In hepatocytes, the primary liver cells that make up 70 to 85 percent of the liver’s mass and carry out the basic functions of the liver, senescence is increased. On the other hand, senescence is decreased in activated hepatic stellate cells, the supportive cells which, when triggered by alcohol or other liver insults, begin to produce excessive fibrotic material.

“Understanding the mechanisms underlying hepatic stellate cell activation and regression has become an increased area of interest,” Meng said, “and our findings help to advance understanding of the complex nature of this phenomenon.”

More broadly, this pathway that regulates hepatic stellate cell activation and regression could potentially be applied to other aging-associated fibrotic liver diseases.

“It is imperative to identify regulatory targets for potential treatment of alcoholic liver diseases, especially for populations that are greatly impacted by this disease,” added Heather Francis, PhD, and Shannon Glaser, PhD, associate professors of medical physiology at Texas A&M, DDRC, CTVHCS, and co-authors of the article. “Our study opens the window for the possibility of linking age-related genes as therapeutics for the future.

This research was partially funded by a VA Merit Award (1I01BX001724) to Dr. Meng, the Dr. Nicholas C. Hightower Centennial Chair of Gastroenterology from Baylor Scott & White, a VA Research Career Scientist Award and a VA Merit award to Dr. Alpini (5I01BX000574), a VA Merit Award (5I01BX002192) to Dr. Glaser, and the NIH grants DK058411, DK076898, DK107310, and DK062975 to Drs. Alpini, Meng and Glaser. Portions of this work were supported by a VA Merit Award (1I01BX003031) from the United States Department of Veteran’s Affairs, Biomedical Laboratory Research and Development Service and an RO1 from NIH NIDDK (DK108959) (HF).